ANTOINE DESHAWN JACKSON

ROSEVILLE, MN
NPI1174278048
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: MN  3145)
Enumeration Date2022-02-18
Last Update Date2024-11-14
Business Address
ANTOINE DESHAWN JACKSON MA, LPCC
2335 WOODBRIDGE ST APT 338
ROSEVILLE, MN 55113-4763
Phone number: 612-715-4071
Mailing Address
ANTOINE DESHAWN JACKSON MA, LPCC
2335 WOODBRIDGE ST APT 338
ROSEVILLE, MN 55113-4763
Phone number: 612-715-4071
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